Prostate cancer: Demographic and behavioral correlates of stage at diagnosis among blacks and whites in North Carolina

Objectives. Although stage at diagnosis is one of the most important predic tors of survival from prostate cancer, demographic factors, screening pract ices, and knowledge and beliefs associated with stage at diagnosis have not been well documented, particularly by race. Methods. We conducted telephone interviews with 117 black and 114 white men diagnosed with prostate cancer to identify the demographic factors, health care-seeking behaviors, and prostate cancer-related knowledge, attitudes, a nd practices associated with stage. The sample was stratified by stage at d iagnosis and was composed of men 50 to 74 years old who resided in a contig uous 63-county region in North Carolina and who were diagnosed at 1 of 16 p articipating hospitals. Results. Among blacks, stage was inversely correlated with income (P = 0.04 ) and health insurance status (P less than or equal to 0.001); among whites , stage was not associated with income or health insurance status, but appr oached significance with marital status (P = 0.06). Awareness of prostate c ancer before diagnosis tended to decline with advancing stage among black m en (P = 0.07), but was high for all stages (greater than 93%) among whites. Report of a prostate-specific antigen screen was inversely correlated with stage among black men (P = 0.01); a trend was observed among whites but wa s not significant (P = 0.20). Knowledge of prostate cancer risk factors was not significantly associated with stage For blacks or whites. Less than on e third of men in each race and stage group knew that black men are at incr eased risk of prostate cancer. Conclusions. Demographic and other factors vary with stage and should be co nsidered when designing and targeting interventions to reduce late diagnosi s of prostate cancer. UROLOGY 53: 1194-1199, 1999. (C) 1999, Elsevier Scien ce Inc. All rights reserved.